HomeMy WebLinkAboutPerino, John 11„" f FOL4.
ELIZABETH A. NEVILLE 1 h`Z` �y ; Town Hall, 53095 Main Road
TOWN CLERK p 1 P.O. Box 1179
ti Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax(516) 765-6145
MARRIAGE OFFICER ` Tele hone (516) 765-1800
RECORDS MANAGEMENT OFFICER O 1 P
� ` 11
FREEDOM OF INFORMATION OFFICER = . ' '�a8'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2152 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JOHN & PATRICIA PERINO
Address 1 : 74 N HEWLETTS PLACE ROAD
City St Zip BELLPORT NY 11713
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF # R10-99-0179
Name Of Owner PERINO, JOHN & PATRICIA
Mailing Address 1 74 N HEWLETTS PLACE RD
City St Zip BELLPOT NY 11713
Property Address 1 475 OLE JULE LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 114.00 block 12 lot 14.003
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 10/01/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
l
ais
11' l i is �,�''I SAF FO�,�0o
ELIZABETH A.NEVIL E ii�0 �y� Town Hall, 53095 Main Road
TOWN CLERK BLDG.DET •
o -'4 % P.O. Box 1179
OF SOU i'r; ' Z Southold, New York 11971
REGISTRAR OF VITAL S t O Fax(516) 765-6145
MARRIAGE OFFICER Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER -o* 4. „•
P
FREEDOM OF INFORMATION OFFICER = '/ 4 �„�
• of
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 14, 1999
Transmitted herewith is a copy of application No. 2238 for a Cesspool/
Septic Tank Construction Permit submitted by:
John and Patricia Perino .
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE l/r
DISAPPROVE
Comments:
ignatu 0
9 1lbet
Dated
.
J -r , ,,,,,,,'-
THE
OFFICE OF TOWN CLERK ,,�' ,,,,,, '
CO OaK
TOWN OF SOUTHOLD %'.. CCG Application No,
F1.i7ABETH A.NEVILLE,TOWN CLERK
i
P.O.BOX 1179 /....
_ Construction
SOUTHOLD,NEW YORK 11971 Z
21 Alteration y.
Telephone 0� �Q�'i1 $10.00 - Residential
(516) 765-1801 - �l roe $25.00 -Non-Residential
—.iv.,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATEy. ,,,k? /99?
APPLICANT NAME: Johll I q -1?)4 6 ed 1.�i4 ;1/.."9 '/�APPLICANT ADDRESS: I -��
A(8 .
w-f:R
SEPTIC CESSPOOL NZ
DESCRIPTION OF PROPOSED CONSTRU ALTERATION
a . _-- --LOO \- rTION OR/ gni I i . ,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED COR CTION ALTERATIO)
OWNER OF PROPERTY: JQ� kI Q c & e/ ' " '( 46
OWNER MAILING ADDRESS: II ('shit - - di
li-1
eIIpoC At . < / '3
OWNER PROPERTY ADDRESS: / -( oL CD/e. itJ' `C -
foitAti #
TELEPHONE NUMBER OF CONTACT PERSON: � (Q,i0 In0
TAX MAP NO. : Section /006 Block 1 /4 Lot /a - /"710 3
CROSS STREET: h1/4eto Get-i----el X ilCV I
BUILDING PERMIT NUMBER CROSS REFERENCE: j /
1 1 1 ,
i .
r•ovii fa , p //r
1 1 a‘Ily
Signature of • .plica t
RECEIVED BY: /
Town Clerk's Office
DATE:
/ ,
Dull LL..
AVIA 11_Re,Le.
Me,J. /.V
DRA,N,
j� -
EL.,5-4,
eB.o
w w w
w
99.0 - OLE.UL/LE �- LA. + +
9C0.70 .4o
34..4096 ;6-,..70CSo' w,D6)
V 4jlo."Co
UT: Poi.E 76 3a.¢O E. �,U T. Po&e /70.DO'
.4 o 1 ti - �s 1 \1s t " '
o
b
N N.
Ai r, Z . , ,
Nv In
L" A'
N sutt_p1 . N t o Pe. ' -. 1.
% zk
0 V 4 r • �� N iv
0
G NiO ! `�. .
�, � _ 8 i N. Cn
6 n' _ o. -- x, P R a P.
PI
,.o, r,TY: pis. w .5o' n Q
II iS d Cr P. 'c 3,o)In or, D
r M,u— Cw za'
r W — N
{ G F ,
`\ Jam, Q I..
® „„
J
I''''1.'N {`;
O
•
\�
µ
o�' r-
GI
4 0
ek ,,-d T.,. .;, .4..' k k s u
�_ r
,,Imo'el
1,...,7,1:;;.„1....„. ;
0 r 4. „. ry
/J� 3d O t a1 4'P„-ik4 H
r r t fv
,, . -- ;;2
n
D
p' 0 P . 0
';3 ,-.1 1_&) q Fr; •
[ ;. '
- ,;,46,,::: :....;1,
Fc J0
_ `` K,
Ill ',.: i I.,4) it,... ,,,
�; b. r s
� A , Aid X00 3 0 � �, '''"' ..,.„coil �
r-I) _11 ,. k II tti ; ). -4-A
..ry C C.. -• i " III > X in or'1 ot I t of 1 tci 1 k 0,11 'ii Iv - .
oL
v
' p \p '�' (A N
6� Z Ni 4
M1�.1 S